Growth industry: UVA, MJH ready for the morbidly obese
UVA's newest hospital building acknowledges a cruel fact of life: Americans are getting fatter–- much fatter. At the swanky new Ivy Road facility designed for long-term acute care, 11 of the 40 rooms can handle patients weighing up to 1,000 pounds, thanks to heavy-duty beds and overhead electric lifts.
"It is very innovative," says Michelle Hereford, associate chief at UVA's new Transitional Care Hospital. "It decreases injuries and helps with patients being mobile."
On a reporter's recent tour of one of the so-called "bariatric" patient rooms, it's evident that the room is bigger than usual. So are the beds, which are reinforced and capable of holding patients who might qualify for the record books.
Overhead, a monorail-like ribbon of steel snakes across the ceiling. That's the track for the Pinnacle brand overhead lift, an electric winch-equipped device that can lift a half-ton patient out of bed and all the way to the bathroom.
Bariatric medicine is booming locally. An estimated 20 to 24 percent of adults in Virginia are obese, according to the Martha Jefferson Bariatric Center, whose website, when one is searching the term "obesity health risk," currently pops up first under sponsored results.
"We already offer bariatric services," says Martha Jefferson spokeswoman Jenn McDaniel. "At the new hospital, all of our rooms are designed to accommodate bariatric patients."
Slated to open next year at Peter Jefferson Place, Martha Jeff's new facility will feature extra-wide doors on all bathrooms and in all patient rooms, and all the beds will hold up to 500 pounds.
"Thousand-pound patients are few and far between for us," explains McDaniel. "We will rent those beds if we need them on a case-by-case basis."
And unlike UVA's Transitional Care Hospital, Martha Jeff opted not to install overhead lifts.
"Our team looked at those and found that most patients don't fall between the bed and bathroom," says McDaniel. "They fall in the bathroom or in the hall. We'll have portable lifts if they need help getting onto machines like MRIs, or between the bed and bathroom if needed."
The two Charlottesville medical centers are not alone. Large patients appear to be fueling a national growth industry.
"Look at the data," says McDaniel. "Overall, Americans are getting larger."
A recent Center for Disease Control Foundation study published in the July 27 issue of Health Affairs pegs the cost of obesity health care in the United States as high as $147 billion, double what it was a decade ago, with half the costs covered by the federal government through Medicare and Medicaid.
James Zervios, spokesman for the Obesity Action Coalition, thinks focusing on what the taxpayer pays is unfair.
"Someone who smokes and gets lung cancer, we don't say my tax dollars shouldn't pay for care," he says. "Someone who sunbathes and gets skin cancer, we don't say we shouldn't pay."
With 93 million Americans affected by obesity, bariatric facilities at hospitals are long overdue, says Zervios, because the care of some large patients is hampered by outmoded equipment.
"We've experienced it a lot with hospitals who can't handle someone of size," he explains, noting that ambulances also need special equipment to properly transport extremely obese patients.
The injury risks of obesity aren't limited to obese people. Nursing aides, orderlies, and attendants reported 24,340 back injuries in 2007, the second highest of all occupations, while registered nurses ranked seventh with 8,580 cases, according to Katherine Cox at the American Federation of State, County and Municipal Employees.
While patient weight wasn't tracked in those numbers, Cox says she wouldn't be surprised if injury rates climb with the weight of the patient, and she points to legislation sponsored by Minnesota Senator Al Franken, the Safe Patient Handling Bill, that would mandate patient lift equipment.
"It's a huge issue we've been working on for a number of years," says Cox. "We'd say back injuries among health care workers is epidemic."
Cox praises new facilities like UVA's and Martha Jefferson's for providing infrastructure to reduce such injuries.
"The problem for some of the older hospitals is that it's not doable," explains Cox. "Think of the weight. You don't want to pull down ceiling tiles."
At UVA's Transitional Care Hospital, the innovations don't stop with the heavy lifting. The facility is primarily designed for weaning patients off ventilators at a cost far cheaper than an ICU. The rooms have their own bedside monitors, in-wall oxygen supplies, and some rooms are pre-plumbed for dialysis.
"It's very innovative," Hereford reiterates. "And," she adds, "patients don't have to be obese to use this equipment."